This report highlights the successes and challenges of permanent supportive housing projects funded as part of the Missouri Foundation for Health’s Show Me Healthy Housing (SMHH) program. In 2014, the Missouri Foundation created SMHH and awarded more than $1 million in grants to four organizations to fund supportive housing projects in Springfield, Hannibal, Columbia, and Mexico, Missouri. The four Missouri permanent supportive housing projects serve various populations, including veterans, seniors, people with serious and persistent mental illnesses, and homeless families.
In this report, we evaluate the effectiveness of SMHH efforts after one year. We find that SMHH sites are making inroads in providing stable housing for vulnerable populations.
Permanent supportive housing combines long-term rental subsidies with community-based services. Tenants typically receive permanent rent subsidies for as long as they remain in the program and have access to case management and support services for house maintenance and personal well-being.
Studies have long shown that permanent supportive housing improves housing stability for people experiencing chronic homelessness—that is, people with disabilities and a long history of homelessness—and reduces preventable hospitalizations and emergency room visits.
With such positive results, the nationwide growth in supportive housing we have seen should not be surprising. From 2010 to 2015, the number of permanent supportive housing beds available nationwide increased 86 percent from 171,472 to 319,212. Over that same span, however, permanent supportive housing beds in Missouri increased only 28 percent from 3,934 to 5,016. This makes the Missouri Foundation’s entrance into the supportive housing field important, given the obstacles many potential tenants face.
In the first year of our evaluation, two of the four supportive housing projects had begun serving tenants. These tenants had multiple barriers to finding and maintaining housing. Fifty-five percent of heads of households in the sites currently housing tenants had been chronically homeless before entering supportive housing, while 91 percent reported having a mental illness, 67 percent reported having a chronic health condition, and 36 percent were in fair or poor health.
SMHH tenants were deeply appreciative for the opportunity to live in their own homes and spoke favorably about the quality of their new housing. The first few months in supportive housing after experiencing homelessness can be disruptive to established routines and leave tenants vulnerable to returns to homelessness or, for those with a history of addiction, drug or alcohol relapse.
That said, SMHH grantees have helped all tenants stay housed during this period. We will analyze promising early indicators of improvements to tenants’ health in more detail in future reports.
Going forward, all sites could benefit from sharing information, including community-building strategies and ways to integrate client feedback, lessons learned, and strategic partnerships. For sites without long-term subsidies, staff must ensure that residents can afford and maintain their housing once subsidies expire.